Subacute invasive pulmonary aspergillosis after chemoradiotherapy for lung cancer

Subacute invasive pulmonary aspergillosis (SIPA), a rapidly progressive fungal infection of less than three months arising from pre ‐existing lung lesions, generally afflicts moderately immunocompromised patients. We herein report the case of a 69‐year‐old man who developed SIPA following chemoradiotherapy for lung cancer and treated with multiple antifungal therapy. Subacute invasive pulmonary aspergillosis (SIPA), a rapidly progressive fungal infection of less than three months arising from pre ‐existing lung lesions, generally afflicts moderately immunocompromised patients. We herein report the case of a 69‐year‐old man who developed SIPA following chemoradiotherapy for lung cancer and treated with antifungal therapy. He presented with fever, and computed tomography revealed a cavit y with surrounding consolidation. The cavity itself had been considered as the primary tumour treated by chemoradiotherapy. Bronchoalveolar lavage by bronchoscopy performed at admission identifiedAspergillus fumigatus; no other pathogens or malignant cells were observed. Owing to the worsening of symptoms and inflammation despite micafungin administration, the treatment was changed to liposomal amphotericin B with voriconazole, which led to clinical improvement. In addition to cancer recurrence and bacterial infection, fungal infection should also be considered in patients undergoing chemoradiotherapy for lung cancer with deteriorating imaging findings and symptoms. In intractable c...

Source: Respirology Case Reports - February 5, 2020 Category: Respiratory Medicine Authors: Hirofumi Watanabe, Toshihiro Shirai, Mika Saigusa, Kazuhiro Asada, Kazumori Arai Tags: Case Report Source Type: research